What we do about health care

There is a lot of discussion online in the RV world about how different folks handle their healthcare issues while traveling around the country. On Medicare or private insurance? In Network or Out of Network? Prescriptions, routine doctor visits, diagnostics, and more issues to consider and work out.

I thought I’d share how things are working out for us.

Employer-Offered Group Plan

Before we hit the road, we had been “self-pay” for about 10 years. That is to say, we had no medical insurance and we had to pay our own way. Kathy had worked for the school system for 25 years where we used the group plan offered there, but the last 5 years or so of her career the school made the decision to terminate all the teacher’s aides and have them re-hired by an outside contractor that did not provide any health benefits.

I had a heart attack in 2003 and as a result could not find any affordable health insurance plan for the both of us once Kathy’s plan was cancelled because of my pre-existing condition.

Since I owned my own small real estate business (an LLC), I was able to find an insurance broker who was able to form a “group of two” for Kathy and me to get some coverage. First year it was $750/month, 2nd year it went to $1000/month, and the third year it went to $1250/month and that was in 2008 when the real estate market was collapsing in Ohio and sales were way down and we had to drop the plan.

We were once again on our own, hoping that nothing catastrophic came along. We continued to pay our own; office visits, prescriptions, diagnostic tests, etc and just prayed that neither of us had a stroke, was diagnosed with cancer, or some other terrible (and costly) disease or ailment.

In 2010 Obamacare was introduced and in due time it became the law of the land and everyone was going to be required to sign up …. or else.

The Obamacare “Silver” plan was going to cost us about $1250/month AND $12,000 out of pocket for a $27,000 annual total cost before they picked up the rest. No thank you sir ….

And then it happened …

In 2013 Kathy was diagnosed with uterine cancer. It was detected early, a total radical hysterectomy was performed and to this day she is cancer free and was not required to go through any radiation or chemo-therapy. We were (and are) truly blessed.

But how did we handle the financial burden associated with such a catastrophic illness?

We found, since we were self-pay, that at the time of registration at the hospital they asked for a small down payment ($500) and a commitment to pay monthly some “agreed upon” amount. At the time I was still working and we agreed to pay $500 every month until the total bill was paid off. We could have committed to as little as $25 monthly. After her surgery and during recuperation the bill came at just about $35,000 but was discounted to approximately $22,000 because we were self-pay. We paid more when we could and got the bill paid off in about 3 years.

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We’ve since found an alternative to paying our own way and/or group health insurance. We found Medical Cost Sharing through Christian Healthcare Ministries. Here’s a quick synopsis of CHM’s programs. We pay $300/monthly for BOTH of us to receive GOLD coverage. Because we also subscribe to their Brother’s Keeper Program, our reimbursement per illness is unlimited. The Brother’s Keeper additional quarterly donation varies, but is usually around $30-$50 per quarter.

With CHM, we are the “Financially Responsible Party” and the bill comes directly to us. We ask for self-pay discounts up front and we generally get them. We submit our bills to CHM and in 2-3 months we are reimbursed. Since it’s a religious based program, this qualifies for an exemption from the requirements of Obamacare. Here’s a link to a 5 minute YouTube video explaining how CHM works.

Urgent Care

Although our doctors are back in Ohio, when we were in Arizona it was necessary for me to go to urgent care for treatment. They had a program where you become a “member” almost like a gym membership and pay a monthly fee so you can go anytime without further cost and you can cancel anytime.

The visit would have cost me $650 (there was a small surgical procedure involved), but under the membership program they offered, I only paid $105 that night (for the first 3 months) and then would have continued to pay $35/month after the first 90 days, but we cancelled the program since we were leaving and heading to Michigan for our summer workamping gig.

Here in Michigan, I again needed to visit Urgent Care at the local hospital for what I thought might have been a sprain in my left hand/thumb. We were greeted and I was served right away (it was an early morning visit), vitals and history were taken by the Physician’s Assistant and then the Doctor met with me and diagnosed Tendonitis. He prescribed rest and a mild inflamatory, and installed a splint.

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We walked out the door paying nothing at the time of service and were billed later a TOTAL of only $100! I believe if I were covered by insurance, the bill would very likely have been at least a few hundred dollars.

Prescriptions and Medications

We pay our own way on prescriptions and medications. We’ve found however, the value in comparison shopping. Again, when we were in AZ last winter, one of my meds was going to cost $453 at CVS, but we got it at Fry’s (Kroger) for $32. Here is a clip I just took from GoodRX.com this afternoon just to show you an example of the varying prices. When you are paying cash for meds, this can make a big difference in the monthly budget.

Kathy uses an insulin pen and has found coupons online for a $100 discount on a 5-pen pack. Although we still pay over $300 for that med, the $100 discount helps.

Last week I needed to refill my statin and found that Meijer offers a FREE 90 day supply. I asked when this offer expires and the pharmacy tech told me it has no end date. Guess I’ll be going to Meijer from now on for that! Free is good!

All in all, we’re pretty pleased with the “HerbnKathy” medical plan. So far this year (Jan-Sept) we’ve spent;

Kathy and I both had need for chiropractic when we were in AZ which made up about $700 of the $1567, and we won’t be needing that any longer.

The other large cost is the $1200 for medicine. We use generics wherever we can, but Kathy’s diabetes pen is brand name, not generic hence the high cost for meds.

Still I feel comfortable with the $800 average monthly costs. Hopefully we can stay generally healthy, at least until Medicare kicks in at 65, (two more years down the road).

I know there’s a lot of different ways to get the health care we need and this is just the way we do it. It’s not the least expensive, it’s not perfect, and there’s always the “what if”, but if we lived our lives around the “what ifs” then we’d live a pretty sheltered life … not the one we choose to live.

I hope you found some value in this discussion that will help you as you weigh your health care options in your full time RV life.

Safe travels, good luck, and by all means …. have fun!

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3 thoughts on “What we do about health care”

This is a good article with lots of alternatives and helpful information. I’m on the retiree medical plan from my old employer (a health care facility). It includes all eligible family members, but the premium wipes out my pension (pension offered by the company, not my personal one). I also have rheumatoid disease requiring a weekly injection and mild chemo that costs thousands of dollars each month that is covered under that plan. The downside is I have to see the same rheumatologist every 6 months/1 year and requires me to be back in Florida for those visits–if I want my meds refilled. It’s such a catch 22 and frustrating because the premium costs have tripled over the last 8 years. If we have an emergency, though, and not near a covered health care provider–we may be in trouble. Dawn

Dawn, if it truly is an emergency then …. In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) to ensure public access to emergency services regardless of ability to pay. Section 1867 of the Social Security Act imposes specific obligations on Medicare-participating hospitals that offer emergency services to provide a medical screening examination (MSE) when a request is made for examination or treatment for an emergency medical condition (EMC), including active labor, regardless of an individual’s ability to pay. Hospitals are then required to provide stabilizing treatment for patients with EMCs. If a hospital is unable to stabilize a patient within its capability, or if the patient requests, an appropriate transfer should be implemented. (copied from CMS.gov) — but we all “keep on truckin” and hope for good things, not worry about what might happen, right?

There is no better way to answer a question than with a blog post. This was very informative and I thank you Herb, for sharing this information. I have bookmarked this post and if I do decide to take early flight from the working world I will utilize it as a starting point for further investigation. You two are Awesome!

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